Changes in Bowel Movements: When to Seek Medical Advice

Bowel issues

Hello, recently my first stool is normal, but the subsequent ones become thinner.
For example, today in the morning (when I felt a sudden urge), the first two pieces (the first one was 8 cm and the second one was 6 cm) had a normal thickness, but the last three pieces (all around 8 to 10 cm) were quite thin, with a diameter of about 2.2 cm (they were still somewhat cylindrical, and I didn't notice any signs of being compressed, but I did see some faint marks on them, which I later wondered if it was because the later stools were softer).
After that, I returned to the classroom and suddenly had abdominal pain, and when I went back to the restroom, the stool was soft and mushy.
I've been in college for about three weeks, during which: (1) I have had mushy stools like today about twice; (2) I have not experienced constipation (but generally, they are thicker at the beginning and thinner at the end); (3) I have seen blood when wiping (bright red), but not in the toilet bowl; (4) sometimes when using a sitting toilet, I notice the stool is loose (it breaks apart in water); (5) sometimes there are marks on the stool, but that is when the later stools are softer; (6) I often feel air moving around in my intestines (not in a specific location), and I have been passing gas more frequently these past three days; (7) I usually have a bowel habit in the morning, but if I have classes, I can wait until the afternoon, and it doesn't matter if I don't go that day; (8) the color is brown with a yellowish tint (more brown pigment), but there are some black specks mixed in.
I am now somewhat worried about colon cancer, although I know the chances at my age are low, I still wanted to ask you if there is a need for any examinations.
Thank you for taking the time to read this.

Dàxuéshēng, 10~19 year old female. Ask Date: 2017/09/28

Dr. Chen Jiaming reply Surgery

I have carefully reviewed your situation, and your bowel movements are quite normal, especially compared to many young people today.
Therefore, there are currently no indications for any examinations.
😊

Reply Date: 2017/09/28

More Info

Understanding changes in bowel movements is crucial for maintaining digestive health, and it can often signal underlying issues that may require medical attention. Based on your description, there are several factors to consider regarding your bowel habits and when to seek medical advice.

Firstly, the fact that your stool varies in thickness, with the first few pieces being normal and subsequent pieces becoming thinner, can be indicative of several conditions. Normal stool should ideally be well-formed and cylindrical. A change in the shape of your stool, particularly if it becomes consistently thin or pencil-like, can be a sign of a narrowing in the colon, which may be caused by conditions such as colorectal polyps or, in more serious cases, colorectal cancer. However, it’s important to note that variations in stool shape can also be influenced by dietary factors, hydration levels, and gastrointestinal motility.

The presence of soft, mushy stools, especially if they occur frequently, may suggest a degree of gastrointestinal distress, which could be due to dietary choices, stress, or even infections. If you are experiencing changes in your bowel habits alongside abdominal pain, increased gas, or changes in the consistency of your stool, it is advisable to monitor these symptoms closely.

You mentioned seeing blood on toilet paper, which can be alarming. While bright red blood can sometimes indicate hemorrhoids or anal fissures, it can also be a sign of more serious conditions, including diverticular disease or colorectal cancer. If you notice blood in your stool or on toilet paper, it is essential to seek medical advice promptly.

The fact that you have experienced increased flatulence and a sensation of air moving in your intestines may suggest that your digestive system is reacting to something in your diet or that there is an imbalance in your gut flora. This could be due to the consumption of certain foods, such as those high in fiber or sugar, which can lead to gas production. Keeping a food diary may help identify any correlations between what you eat and your gastrointestinal symptoms.

Given your concerns about colorectal cancer, it is understandable to feel anxious, especially since you have noted some unusual changes in your bowel movements. While the likelihood of developing colorectal cancer at a young age is relatively low, it is not impossible, and being proactive about your health is important. If you have a family history of colorectal cancer or other risk factors, it would be prudent to discuss these with a healthcare provider.

In summary, here are some guidelines on when to seek medical advice regarding changes in bowel movements:
1. Persistent Changes: If you notice a consistent change in the shape, size, or consistency of your stool over a period of weeks.

2. Blood in Stool: Any presence of blood, whether bright red or darker, should be evaluated by a healthcare professional.

3. Abdominal Pain: If you experience significant or persistent abdominal pain, especially if it accompanies changes in bowel habits.

4. Changes in Bowel Habits: If you experience diarrhea or constipation that lasts more than a few days or is accompanied by other concerning symptoms.

5. Family History: If you have a family history of gastrointestinal diseases, including colorectal cancer, it is wise to discuss screening options with your doctor.

In conclusion, while some variations in bowel movements can be normal, significant changes warrant attention. It is always better to err on the side of caution and consult with a healthcare provider who can perform a thorough evaluation, possibly including a physical examination and diagnostic tests, to rule out any serious conditions. Taking these steps will help ensure your digestive health and peace of mind.

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